Provider Demographics
NPI:1700018496
Name:MASON, FAITH BARBARA (MA)
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:BARBARA
Last Name:MASON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 3RD ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0511
Mailing Address - Country:US
Mailing Address - Phone:707-599-5962
Mailing Address - Fax:707-441-1053
Practice Address - Street 1:837 3RD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0511
Practice Address - Country:US
Practice Address - Phone:707-599-5962
Practice Address - Fax:707-441-1053
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist